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Posterior reversible encephalopathy

Lei Zhang, Jian Xu
Posterior reversible encephalopathy syndrome (PRES) is a rare clinical entity associated with systemic lupus erythematosus which characterized by seizure, headache, and altered mental status. The pathophysiology involves subcortical vasogenic edema secondary to hypertension and endothelial damage. PRES is reversible with withdrawal of the offending agent, strict blood pressure control, and treating the underlying disease. We report present here a patient with lupus nephritis who developed PRES following mycophenolate administration...
2018: American Journal of Clinical and Experimental Immunology
Eiichi Katada, Akira Mitsui, Shigeru Sasaki, Norihiko Uematsu, Chise Anan
A 44-year-old woman with advanced metastatic colon cancer received chemotherapies comprising XELOX, FOLFIRI/panitumumab and mFOLFOX6/bevacizumab. Fifteen months later, she presented with the acute onset of a headache, drowsiness and seizure with a fever and hypertension. Brain magnetic resonance imaging (MRI) indicated bilateral regions of signal hyperintensity in the white matter with spasms of bilateral cerebral arteries apparent on magnetic resonance angiography. Posterior reversible encephalopathy syndrome (PRES) was diagnosed, and treatments resulted in improvement of the MRI findings, but the patient experienced cerebral infarction and ultimately died of deterioration of cancer on day 26 after the onset of PRES...
March 9, 2018: Internal Medicine
Manveer Garcha, Keithan Sivakumar, Mohammed El-Hunjul, Shweta Varade, Hussam A Yacoub
Posterior reversible encephalopathy syndrome (PRES) is clinically characterized by seizures, changes in vision, altered mental status, and headache, with associated radiologic changes on brain imaging. Intraparenchymal hemorrhage is a rare complication of PRES and an atypical initial presentation of this condition. In this report, we discuss two patients who presented with multifocal cerebral hemorrhages that were later attributed to PRES. We further expand on the pathophysiology, management, and prognosis on patients with hemorrhagic PRES...
March 8, 2018: Hospital Practice (Minneapolis)
Sang-Woo Lee, Seung-Jae Lee
Posterior reversible encephalopathy syndrome (PRES) is a disorder of reversible vasogenic brain edema which mainly involves the parieto-occipital lobes in various clinical settings. The main mechanism is known to be cerebral autoregulation failure and endothelial dysfunction leading to the disruption of the blood-brain barrier. We report the case of a 47-year-old woman with PRES which involved the brain stem and thalami, sparing the cerebral hemispheres. She was admitted to the emergency room because of acute-onset confusion...
January 2018: Case Reports in Neurology
Anas Alrohimi, Rajive Jassal
Headache is an uncommon symptom in Guillain-Barré syndrome (GBS). We review four clinical settings related to GBS in which headache may be present. We focus on pathophysiological explanations, alerting the clinician to further potential investigations and treatment. Most reports of headache in GBS occur in the context of the posterior reversible encephalopathy syndrome, an increasingly recognized dysautonomia-related GBS complication. Less frequent is headache in the setting of increased intracranial pressure and papilledema (secondary intracranial hypertension), Miller Fisher syndrome, and cerebral venous sinus thrombosis...
March 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Aakriti Pandita, David F Lehmann
Posterior reversible encephalopathy syndrome (PRES) is a potentially reversible failure of cerebral autoregulation managed by correction of hypertension or underlying medical condition. Nonresponding cases progress to irreversible brain damage. There is some evidence of association of hypomagnesemia with PRES. We describe a case of nonresolving PRES where use of magnesium sulfate led to improvement in neurological function and eventual recovery. Our case highlights the need for a randomized controlled trial to test the efficacy of magnesium in PRES...
March 2018: Neurologist
Olaf Eberhardt
The urgency and intensity of therapeutic response to a hypertensive crisis are governed by the presence or absence of acute end-organ damage, which define hypertensive emergency and hypertensive urgency, respectively. In case of hypertensive urgency a slow and moderate lowering of blood pressure by oral antihypertensive agents seems adequate, while the approach to hypertensive emergency has to be tailored to the specific type of organ failure. Optimal blood pressure management in the context of neurovascular emergencies is made difficult by contradictory data from observational and interventional studies...
February 28, 2018: Fortschritte der Neurologie-Psychiatrie
Joseph B Miller, Kushak Suchdev, Namita Jayaprakash, Daniel Hrabec, Aditya Sood, Snigdha Sharma, Phillip D Levy
PURPOSE OF REVIEW: This review summarizes the latest science on hypertensive encephalopathy and posterior reversible encephalopathy syndrome (PRES). We review the epidemiology and pathophysiology of these overlapping syndromes and discuss best practices for diagnosis and management. RECENT FINDINGS: Diagnosis of hypertensive encephalopathy largely relies on exclusion of other neurological emergencies. We review the extensive causes of PRES and its imaging characteristics...
February 26, 2018: Current Hypertension Reports
Andrew King, Mirjana Dimovska, Luke Bisoski
PURPOSE OF REVIEW: Acute drug-induced hypertension, sympathomimetic toxicity, and other hyperadrenergic states can be caused by both xenobiotic toxicity and withdrawal. This manuscript is a selective review of the recent literature regarding pharmacologic causes of hypertensive emergencies and other hyperadrenergic states. RECENT FINDINGS: We will discuss designer stimulants, alpha2 and baclofen agonist withdrawal, and the clinical entity known as posterior reversible encephalopathy syndrome (PRES)...
February 24, 2018: Current Hypertension Reports
(no author information available yet)
No abstract text is available yet for this article.
March 2018: MCN. the American Journal of Maternal Child Nursing
Courtney Stanley Sundin, Michelle Laurane Johnson
Posterior reversible encephalopathy syndrome (PRES) is a newly defined syndrome; therefore, this transient clinical condition is not well known and probably underdiagnosed. It develops quickly with symptoms that are usually indistinguishable from eclampsia. Nurses need to be knowledgeable and aware of identifying symptoms and appropriate treatment. The condition is thought to share pathophysiology with eclampsia, and it is suggested that endothelial dysfunction combined with hypertension causes disruption in the blood brain barrier resulting in cerebral edema...
March 2018: MCN. the American Journal of Maternal Child Nursing
Michael Chia-Yen Chou, Chia-Yi Lee, Shih-Chun Chao
Posterior reversible encephalopathy syndrome is a clinical phenomenon associated with headache, altered mental status, seizures, and visual disturbances along with radiographic acute cerebral oedema. Several conditions are correlated with posterior reversible encephalopathy syndrome, with acute hypertension, eclampsia, and cytotoxic agents being the most common. This report presents a case of posterior reversible encephalopathy syndrome in a 45-year-old male with multiple underlying conditions, including hypertension, diabetes, and end-stage renal disease...
February 2018: Neuro-ophthalmology
M Yigit, E Yigit, K A Turkdogan
Posterior reversible encephalopathy syndrome (PRES) is an entity characterized by headache, altered mental status, seizures, visual disturbances, and focal neurological signs. The most common etiologies of PRES are hypertension and renal failure, and the most frequent pathophysiology is hyperperfusion. PRES is generally symmetrical, often in the occipital and parietal lobes, and is typically characterized by vasogenic edema in the subcortical white matter. This study involves a 38-year-old female patient who had hypertension, used immunosuppressive drugs and was also found to have nephropathy...
February 2018: Nigerian Journal of Clinical Practice
Kapil Bhalla, Deepali Garg, Mahima Rajan, Jaya Shankar Kaushik, Geeta Gathwala
Nephrotic syndrome is a prothrombotic state with predisposition to venous sinus thrombosis and arterial vascular stroke. Watershed infarcts in junction of arterial territory develop in hypotensive hypovolemic state. These border zone infarcts are usually bilateral in the absence of unilateral arterial stenosis or microembolism. We report a 6-year-girl of frequently relapsing nephrotic syndrome who developed sudden onset hemiparesis with aphasia. Magnetic resonance (MR) imaging brain revealed unilateral watershed infarct in territory between the major cerebral arterial vessels with evidence of restricted diffusion and normal vessel anatomy on MR angiography...
January 2018: Journal of Natural Science, Biology, and Medicine
Amy Louise Ross Russell, Martin Prevett, Paul Cook, Charles Simon Barker, Ashwin Arnold Pinto
Magnesium is the second most abundant intracellular cation. Deficiency can cause several neurological complications, including cerebellar syndromes, with various MRI findings. These include cerebellar oedema, presumably through a similar mechanism to that in posterior reversible encephalopathy syndrome (PRES). People particularly vulnerable to deficiency include those with high alcohol consumption, excessive loss due to gastrointestinal pathology and those taking certain medications, including proton pump inhibitors...
February 15, 2018: Practical Neurology
Mollie McDermott, Eliza C Miller, Tatjana Rundek, Patricia D Hurn, Cheryl D Bushnell
No abstract text is available yet for this article.
February 8, 2018: Stroke; a Journal of Cerebral Circulation
Ryuta Kinno, Hideaki Ohashi, Yukiko Mori, Azusa Shiromaru, Kenjiro Ono
A 28-year-old right-handed man noticed weakness in his legs, three days after an ephedrine overdose. Initial brain magnetic resonance imaging showed lesions in the parietal regions bilaterally. Computed tomography angiography showed segmental and multifocal vasoconstriction of the cerebral arteries. After treatment, clinical and radiological findings resolved, suggesting the patient had reversible cerebral vasoconstriction syndrome with posterior reversible encephalopathy syndrome. However, he had residual agraphia of the left hand...
March 2018: ENeurologicalSci
Zina Hijazi, Peter Lange, Rosie Watson, Andrea B Maier
BACKGROUND: This study aims to investigate the frequency and patterns of use of cerebral imaging in delirium and to describe pathological changes associated with delirium using computed tomography (CT) and magnetic resonance imaging (MRI). METHODS: This retrospective observational study included patients with delirium admitted to a tertiary hospital (The Royal Melbourne Hospital, Australia) between January 2015 and August 2016. Data on cerebral imaging was collected and positive imaging findings were defined as: Acute or subacute infarct, haemorrhage, abscess, neoplasm, vasculitis, posterior reversible encephalopathy syndrome, encephalitis, acute demyelination, or fat embolism...
February 6, 2018: European Journal of Internal Medicine
Mercedes Moreiras-Plaza, Francisco Fernández-Fleming, Naiara Azkárate-Ramírez, Walfred Nájera-de la Garza, Isabel Martín-Baez, Maria Hernansanz-Pérez
Posterior reversible encephalopathy syndrome is a clinical and radiological entity with acute or subacute neurological presentation associated with brain lesions that primarily affect the white matter of the posterior regions. It is often associated with the rapid onset of severe hypertension and/or with kidney failure (acute and chronic), but it has also been reported as a neurological complication in several medical conditions. In recent years, there has been an increase in the number of cases and related publications due to the advance of diagnostic imaging techniques...
February 3, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Chen Makranz, Salome Khutsurauli, Yosef Kalish, Ruth Eliahou, Luna Kadouri, John Moshe Gomori, Alexander Lossos
Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome characterized by headaches, seizures, a confusional state and visual disturbances associated with transient predominantly bilateral posterior white mater magnetic resonance imaging lesions. It is primarily reported in the setting of hypertension, acute renal failure, peripartum eclampsia, autoimmune disease, immunosuppression and chemotherapy. Thrombotic microangiopathy (TMA), including hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) has also been reported as potential PRES inducer...
January 2018: Molecular and Clinical Oncology
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